The activity of the Research Center for Aging mainly focuses on clinical issues of gerontological and geriatric interest, in particular frailty, multimorbidity, polypharmacy and related management, sarcopenia, and geriatrics syndromes, such as delirium and dysphagia. Research activities are included, for the most, in multicentre research projects carried out in collaboration with major national and international geriatric research institutes.
Recent studies to which our Research Center has provided an important contribution include the SPRINT-T (Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies) and the SENATOR (Development and clinical trials of a new Software Engine for the Assessment & optimization of drug and non-drug Therapy in Older peRsons).
The SPRINT-T was a multicenter interventional study, coordinated by prof. Bernabei of the “Università Cattolica del Sacro Cuore”, which involved 11 European countries and was funded by IMI (Innovative Medicines Initiative), a public-private partnership supported by the European Commission and the European Federation of Pharmaceutical Industries and Associations (Efpia). The study, started in 2014 and ended in 2020, aimed at providing a scientifically based definition of physical frailty & sarcopenia (PF&S), a condition that predisposes to the development of mobility disability. The SPRINT-T project included a large-scale randomized clinical trial aimed at verifying the efficacy of a multi-component intervention (based on physical activity, nutritional counseling and innovative technologies) compared to an educational program in the prevention of mobility disability in a population of community dwelling older adults with PF&S.
The SENATOR project, which began in 2012 and ended in 2018, was funded by the European Union and involved a consortium of 12 European organizations. In order to improve the appropriateness of drug and non-drug therapies in complex older patients who are managed by non-geriatric physicians, the project aimed to create a software to optimize therapy and minimize adverse drug events (ADEs), inappropriate prescriptions, polypharmacy and associated excessive costs in older patients with multimorbidity admitted to hospital wards other than the geriatric ward. To verify the effectiveness of SENATOR, a multicentre randomized controlled study was carried out, which included 1800 older patients with multimorbidity, hospitalized with acute diseases, under the care of non-geriatric specialists.
Among the ongoing projects, the iKascade (Identifying Key Prescribing CASCADes in the Elderly: A Transnational Initiative on Drug Safety) started in 2019 deals with an important aspect of the management of drug therapy in older patients, the prescribing cascade, a phenomenon that occurs when a side effect of a drug is misinterpreted as a new medical condition resulting in a new medication being prescribed. Women are more likely to receive potentially inappropriate drug therapies and to experience adverse events. The project will analyze databases from five countries - Belgium, Canada, Israel, Ireland and Italy - to create a comprehensive prescription cascade inventory, it will examine and compare the frequency of prescribing cascade by gender and country in different care settings (hospital, long-term care facilities and community) and it will investigate whether sex and gender are associated with the development and impact of prescribing cascade.
Another important ongoing study is the GED-UP study (Geriatric vs. traditional Emergency Departments: a prospective evalUation of Patients outcomes and healthcare costs) started in 2019. The hypothesis of the study, which involves 3 Italian regions, is that the management of complex older patients in a specialized geriatric emergency room (ER) (an ER with medical staff specialized in geriatrics with experience in emergency medicine and trained nurses; on-demand availability of social workers; systematic screening of high-risk geriatrics conditions using specific tools) might reduce hospitalization and re-hospitalization rates, as well as improve short and medium-term outcomes in older adults suffering from acute diseases, compared to the traditional ER care-model.
As part of the INTEGRATE-HEALTH-GOV network project (definition and testing of a new clinical governance model based on the integration of tools such as health technology assessment, clinical practice guidelines, clinical pathways and the evaluation of the health services for the planning, implementation and management of health interventions in different contexts) our Department coordinates the project GET HEALTH - Geriatric remote management of health conditions in older adults recently discharged from the hospital living in long term care facilities. In fact, hospitalization seems to increase disability and mortality in institutionalized patients. The hypothesis underlying the study is that the implementation of a governance model of geriatric remote management in collaboration with the primary care physician and the nursing home staff can reduce hospitalization, improve patient outcomes and reduce health care costs in this population. The project, which began in 2020, involves 8 Italian hospitals. IRCCS-INRCA taking care of the activities of the work-package 4.
Our Research Centre on Aging and IRCCS-INRCA also collaborate with the InCHIANTI study group from the early stages of the project